DRC - Kwango: At least 37 confirmed deaths due to epidemics of undiagnosed origin reported in Panzi - November 30, 2024+ - malaria, H1N1pdm09 influenza confirmed

[Treyfish]

An unknown flu-like disease has broken out in Kwango Province in southwestern Democratic Republic of Congo (DR Congo). The Africa Centers for Disease Control and Prevention (AfricaCDC) said on December 5 that 79 people have died so far, and the test results are expected to be available on December 6 or 7. The World Health Organization said on December 6 that it has sent experts to the area to support Congo in strengthening disease diagnosis in remote areas.


The Africa CDC released data on the unknown epidemic on social media, saying that from October 24 to date, a total of 376 cases have been recorded in Kwango Province, of which 79 people have died. Among these patients, the proportion of female patients is relatively high. According to the data from the authorities, 198 of them are children under 59 months old, accounting for more than half, and 17 of them have died.




In addition, 28 people aged 5 to 9 were infected and 4 died; as for the groups aged 10 to 14 and 15 to 19, 1 person each died.

Authorities said patients' symptoms included headache, fever, difficulty breathing and anemia, and most patients reportedly died at home without receiving treatment.

The Democratic Republic of Congo's government urgently dispatched epidemiologists to the area to collect samples and clarify the source of the disease. Provincial Health Minister Apollinaire Yumba advised the public to be cautious and not to touch the bodies of the dead to avoid contamination. He called on domestic and international partners to provide medical supplies to respond to the health crisis.

https://news.creaders.net/world/2024/12/06/2805598.html

[Treyfish]

Thailand warns of 'Disease X' in DR Congo

Friday, December 6, 2024 23:05 |

According to a VNA correspondent in Bangkok, the Thai Ministry of Health has sent a warning to all its offices about an outbreak of infectious disease in the Democratic Republic of Congo that has sickened hundreds of people and killed at least 79 since late October.

Ministry official Opas Kankawinpong said all Thai health authorities have been asked to closely monitor people's movements and any updates on the disease, although Thailand is considered a low-risk country. The main focus is on all health checkpoints at border crossings and airports as these are the front lines for tourists to the country.
Bangkok’s Suvarnabhumi Airport has not yet announced any specific measures to prevent the disease. Meanwhile, Hong Kong International Airport (China) has tightened screening measures for all flights from transit hubs in Africa since December 5. In Japan, the Ministry of Foreign Affairs has advised people to avoid non-essential travel to areas affected by the epidemic..

https://baotintuc.vn/the-gioi/thai-lan-canh-bao-ve-benh-x-tai-chdc-congo-20241206230254986.htm

[Treyfish]

Patient with flu-like symptoms isolated at Cleveland hospital after Africa trip. What we know

Cleveland patient with illness just returned from trip to Tanzania in Africa. Meanwhile, authorities investigate mysterious, flu-like disease that has killed 143 in Congo, which borders Tanzania.

Chad Murphy
Akron Beacon Journal
A patient displaying flu-like symptoms is being isolated at University Hospitals in Cleveland after recently returning from a trip to Africa, 19 News is reporting, where a mysterious illness has killed more than 100 people in Congo.

Here's what to know. Patient in isolation had just returned from Tanzania


UH staff are “utilizing proper masking and isolation protocols,” 19 News reports, after a patient with flu-like symptoms arrived to UH St. John Medical Center’s Emergency Department.

A hospital spokesperson told the station that the patient recently traveled from Tanzania to Cleveland Hopkins International Airport.

The patient is isolated and under evaluation, according to the spokesperson, and their condition has been reported to the Ohio Department of Health...

The cases are centered in Congo's southwestern province, Kwango, where at least 376 people have been infected since October, according to the website FluTrackers.com, which cites local sources.....

https://www.dispatch.com/story/news/...o/76822017007/

[sharon sanders]

Someone asked me what I thought this disease is and I replied:


Well...the DRC has so many disease problems that it literally could be anything. Additionally, much of the population there is malnourished and not at their optimal health. Even mild seasonal flu could cause increased deaths.

Here are examples of the disease situations (scroll to the last post on each thread to see the latest):

DRC - Measles outbreak 2024

DRC - Mpox (monkeypox) outbreak 2024

DRC - Polio 2024

DRC - Cholera outbreak 2024

DRC humanitarian crisis 'world's most neglected', says UN

DRC - Malaria outbreak 2024

DRC - Viral conjunctivitis outbreak 2024

DRC - Anti-Ebola vaccination campaign in the province of Équateur: nearly 75% of the targeted population receives the first dose


Sad and impossible.

[alert]

It also says something about what it means for an illness to be "flu-like", that diagnoses for this event have ranged from COVID to Ebola, from seasonal flu to malaria, and from measles to meningitis. Until you actually run the laboratory tests, you don't know much at all.

[Treyfish]

Italy ..

Congo and mysterious epidemic, what should Italy do? Ciccozzi: “Monitoring immediately, also on flights”. Bassetti: “That country is Pandora's box for viruses”

The epidemiologist: “The real problem is the lack of information, even more relevant less than 20 days from the Jubilee. We do not know how many people are infected. Furthermore, the virus has not yet been isolated, I wonder why” What Italy must do (also in view of the Jubilee)

Now, Ciccozzi recalls, " the WHO has sent a team of specialists to Congo to investigate. The hope is that the presumed virus will be identified and sequenced. Only after this step do we know what we are talking about. With today's systems, even 24 hours are enough to get the result". “Monitor incoming flights from Congo”

But what should Italy do, especially now that we are on the threshold of the Jubilee? “We must set up a national epidemiological monitoring. Every time we record flu-like cases, we must understand what it is, even with a swab , to rule out that it is the flu or Covid. I would add: for the Jubilee I would not say make the mask mandatory but strongly recommended on the metro. And it is also very important to monitor all incoming flights from Congo”...

https://www.quotidiano.net/roma/congo-malattia-giubileo-cosa-fare-hrpq6htf

[Treyfish]

Into the unknown: Crack WHO team journeys deep into the Congo to identify mystery killer


Their urgent mission is to find out what is killing swathes of people in one of the most remote parts of the world
Paul Nuki. Maeve Cullinan. Arthur Scott-Geddes. Sarah Newey
06 December 2024 6:17pm GMT
Early tomorrow morning, four stripped-down Toyota Land Cruisers carrying a team of nine doctors, epidemiologists and other outbreak specialists will set off on a 508 mile drive across the Congo in a bid to identify a mystery illness that appears to be killing at will.

The journey will be both arduous and dangerous. The zone in which 394 people are reported to have been sickened by a possible new Disease X – with up to 74 dead – is one of the most remote on earth.

There are no paved roads to Panzi, the small village of tin-roofed shacks surrounded by thick rainforest which is thought to be ground zero for the outbreak, and their progress will be slowed by heavy seasonal rains and the threat of attacks from local militia groups.

Instead, they will have to travel along the rutted dirt tracks that wind south-east from the capital, Kinshasa, through the rough terrain of Kwango province, which takes its name from a river that has long been a target for illegal diamond mining.

The team has been scrambled by the World Health Organization’s (WHO) Health Emergencies directorate run by the veteran epidemiologist and former trauma surgeon Dr Michael Ryan....
Dr Ryan’s unit confirmed it was tracking an “undiagnosed disease in a remote area” of the Democratic Republic of Congo (DRC) on Thursday.

“As of December 4, the Panzi health zone in Kwango Province in the Democratic Republic of the Congo (DRC) has recorded 394 cases and 30 deaths (Case Fatality Rate: 7 per cent) from a so far undiagnosed illness,” it said in a statement...

The WHO team will join a local rapid response unit which set off towards Panzi on Thursday evening.

The two groups include epidemiologists, clinicians, laboratory technicians, infection prevention and control experts, and risk communication specialists.

They are carrying essential medicines, diagnostic and sample collection kits to help rapidly analyse and determine the cause of the illness.

.....

“This is exactly the way that the pandemic first arose in Wuhan,” said Prof James Wood, an expert in infection dynamics and control of diseases at Cambridge. “[Then] we were hearing of a number of cases of unexplained pneumonia.”
But while a new Disease X (a novel pathogen like Covid that we have no existing vaccine for) is the worst case scenario, it is not the most likely.

The WHO was keen to stress on Friday that the remoteness of the region made the possibility that the culprit was a known and treatable disease all the more likely.

“This is a remote area with limited laboratory and other health capacity (there is no laboratory in the region), so it’s possible that it’s an existing pathogen that hasn’t yet been diagnosed.

“This is an undiagnosed disease rather than an unknown [one] at this time,” it said.

....


It is also possible the deaths have been caused – not by a pathogen – but a mass poisoning of some sort, either man made or natural.

...

Yet many are still braced for the worst, with Hong Kong and Thailand already introducing border checks to screen passengers from the Congo for the disease.

“We’re waiting and monitoring very closely,” said Dr Jason Kindrachuk, associate professor in Medical Microbiology and Infectious Diseases at the University of Manitoba, Canada.

“The big piece we’re trying to find out is what the underlying agent causing this is … It seems to be respiratory, and there seems to be a very high morbidity and mortality amongst women and children.”

Even if the pathogen is new and difficult to defend against, the location of the outbreak may ultimately work in our favour.

While Wuhan was connected to the rest of the world by a major international air hub, Panzi is about as distant from the modern world as it is possible to get. The authorities in DRC are also well practised at fighting new outbreaks.

“The DRC is an old hand at doing this kind of [work]... they’ve faced mpox, they’ve faced Ebola, they’ve faced Covid, they’ve faced measles – there’s a huge amount of expertise on the ground with emergency infectious disease response,” said Dr Kindarchuk.

“Unquestionably, they’re in the best position possible to be able to ID this as quickly as possible”.

All we can have to do is wait until they get there – and report back.

https://www.telegraph.co.uk/global-h...go-africa-who/

[Pathfinder]

Translation Google

Unknown disease in Panzi: civil society calls on the population to remain calm

Published on Sat, 07/12/2024 - 13:02 | Modified on Sat, 07/12/2024 - 13:09

ASBL Action Plus, a local civil society structure working in particular in the health sector, called on the population on Saturday, December 7, to remain calm and not to panic in the face of the unknown disease that is decimating the population in the Panzi health zone located in the Kasongo-Lunda territory (Kwango).

The Government is working and experts are already on the ground to deal with this disease which has not yet been diagnosed, assured Jude Tshangata, the coordinator of this non-profit organization, during an interview with Radio Okapi.

He mentioned in particular the provincial health minister and his entourage, who are "working hard on the ground" to determine the true nature of this disease.

Jude Tshangata instead called on the local population to strictly respect the hygiene rules issued by the health authorities, to limit the transmission of this disease which has not yet been diagnosed:

"What we are asking the population is to apply preventive measures because until now, the disease is not yet known. This is why (the inhabitants) must protect themselves, wash their hands regularly with soap, apply barrier measures as required by health professionals."

According to him, it is about not touching anywhere, not greeting each other with the hand, and hygiene is also required.

More than 130 deaths

Regarding the symptoms of this unknown disease, he said: "Often in the sick, there is fever, cough, as well as anemia, and without many days, the person (dies) directly."

As of November 25, the provincial Minister of Health, Apollinaire Yumba Tiabakwau, already put forward a provisional figure of 131 deaths due to this pathology.

However, the medical team deployed in the Panzi area, composed of epidemiologists, laboratory technicians and other health professionals, faces many difficulties that hamper their work:

logistical problems
mobility issues on the ground
lack of funds to carry out the response
insufficient staff

https://www.radiookapi.net/2024/12/07/actualite/sante/maladie-inconnue-panzi-la-societe-civile-invite-la-population-au-calme

[Treyfish]

Lucca patient with Congo disease symptoms, samples tested

Hospitalized from November 22 to December 3, already recovered

ROME, 08 December 2024, 14:57

ANSA English Desk

A man returning from Congo who presented flu-like symptoms potentially attributable to the disease that is affecting a region of the African country was hospitalized in Lucca in recent days and has already been discharged, Maria Rosaria Campitiello, Head of the Prevention Department of the Ministry of Health, said Sunday.
The patient was hospitalized in the San Luca hospital in Lucca from November 22 to December 3, the day he was discharged because he had recovered.
This morning the Lucca hospital informed the Istituto Superiore di Sanità which is monitoring the situation.
The ministry is proceeding with the necessary checks and the samples taken will be analyzed by the Istituto Superiore della Sanità (Higher Health Institute, ISS).
On Friday some 140 people were reported to have died of the mystery disease in Congo, but this toll was slashed to around 30-40 on Saturday.

https://www.ansa.it/english/news/general_news/2024/12/08/lucca-patient-with-congo-disease-symptoms-samples-tested_9bdbdc88-072a-4ea0-aa25-edeb7d061885.html

[Treyfish]

Lucca patient had fever and anemia, 'no risk of contagion'

Works 700 km from outbreak, contacted by Spallanzani for tests


Lucca man who returned from Congo with symptoms of the new mystery disease that has killed dozens of people in the African country had fever and anemia but there was no risk of contagion, the Tuscan city's hospital's infectious disease chief said Sunday.
"The man who returned to Lucca works in Congo 700 km from the area where the outbreak was documented," said Spartaco Sani, head of infectious diseases at the San Luca hospital in Lucca, "He had been hospitalized with fever and anemia, now he is fine.
Just to be on the safe side, he was contacted again for tests, but to date there is no risk of contagion".
The man had flu-like symptoms potentially attributable to the disease that is affecting a region of the African country.
The patient has been contacted again in the last few hours by the Spallanzani National Institute for Infectious Diseases, Italy's premier hub in the sector, for further tests.

https://www.ansa.it/english/news/general_news/2024/12/08/lucca-patient-had-fever-and-anemia-no-risk-of-contagion_97e6e194-d8e8-4033-93ea-8a6809610c79.html

Lucca patient had fever and anemia, 'no risk of contagion' (2)

https://www.ansa.it/english/newswire/english_service/2024/12/08/lucca-patient-had-fever-and-anemia-no-risk-of-contagion-2_d14d3b87-985f-4f33-a723-73a2f787e509.html

[Treyfish]

Unknown disease in Panzi: at least 10 new cases and one death recorded in one day

Published on Sun, 08/12/2024 - 17:40 | Modified on Sun, 08/12/2024 - 17:40


At least ten new suspected cases and one death from the unknown disease which is raging in the health zone of Panzi (Kwango) were recorded during the day of Friday, December 6.
This brings the total to 416 cases with 135 deaths since the disease first appeared a few weeks ago. Of the deaths, only 31 occurred in healthcare facilities.
According to health sources on site, the teams are working hard to put an end to this disease. For the moment, the activities carried out on the ground include: updating the linear list, continuing investigations in the community and in health facilities, delivering medicines to the Panzi General Hospital for the treatment of suspected cases, and raising awareness among the population of the health areas of Kanzangi, Tshakalapanzi and Makita.
To date, the number of affected health areas has increased from 7 to 9, report the same sources.

https://www.radiookapi.net/2024/12/08/actualite/sante/maladie-inconnue-panzi-au-moins-10-nouveaux-malades-et-un-deces

[Treyfish]

Congo Disease, Patient Hospitalized in Lucca Recovered and Discharged

2 min read 08/12/2024 Simona Mastropaolo


The man who returned from Congo with flu-like symptoms potentially attributable to the disease that is affecting a region of the African country has been discharged because he recovered. The patient was hospitalized at the San Luca hospital in Lucca from November 22 to December 3.
Spartaco Sani, head of infectious diseases at the Lucca hospital, explains: “The man who returned to Lucca works in Congo, 700 km from the area where the outbreak was documented. He had been hospitalized with fever and anemia, but is now fine . Just to be on the safe side, he was contacted again for tests, but to date there is no risk of contagion”. The hospital has informed the Istituto Superiore di Sanità, which is monitoring the situation and will analyze the samples taken, while the ministry is carrying out its own investigations. This mysterious epidemic that has spread in Congo has affected over four hundred people and has already claimed at least 70 victims .

Flight checks have started, as is usual, and the WHO has sent experts to the site. The symptoms are fever, headache, cold and cough, difficulty breathing and anemia. Professor Massimo Ciccozzi of the Campus Biomedico in Rome says that it is certainly infectious, probably viral, but we don't know enough about it. "There is no point in creating alarmism.
Given the deaths in the villages, it could be zoonosis, but we don't have data yet. The fundamental concept is that we need to learn to think in terms of Global Health, global health, because Congo seems far away but it is not. We need epidemiological monitoring with attention to flights to Italy , checking people with flu-like symptoms with swabs in order to exclude certain diseases. In Italy, for the Jubilee, we will have 38 million pilgrims in a year, we need to carry out epidemiological monitoring at a regional level too. Today, you can change continents in 12 hours, it is essential to pay greater attention to what a large population movement can entail".



https://www.art-news.it/malattia-del-congo-guarito-e-dimesso-il-paziente-ricoverato-a-lucca/

[alert]

With no respiratory symptoms, this sounds like suspected malaria. I wonder if he was tested for this and if results are known. How much of the larger outbreak is due to malaria as well remains to be determined.

[Treyfish]

Honduras keeps a close eye on an unknown disease in the Democratic Republic of Congo

December 8, 2024

Health authorities in Honduras have announced that they are "closely monitoring" a disease of unknown origin, of which 394 cases have been detected, including at least thirty deaths in the Democratic Republic of Congo (DRC).
The Honduran Ministry of Health said in a statement that it is "closely monitoring a disease of unknown origin reported in the province of Kwango, in the Democratic Republic of the Congo."
He noted that the pathogen appears to be similar to influenza viruses, causing symptoms such as cough, fever, headaches, runny nose, shortness of breath and anemia.
So far, Honduras has not reported any suspected cases of the disease, which mainly affects young people over 15 years of age and represents a greater risk for people with asthma, allergies, HIV and bronchitis, he added.
Honduran authorities have taken preventive measures at border crossings, evaluating all people entering the country, especially those with symptoms, according to the health institution.
The Honduran Ministry of Health urged the population to wear a mask in crowded places or during international travel, wash their hands frequently and see a doctor if they experience breathing difficulties....

https://confidencialhn.com/honduras-vigila-de-cerca-una-enfermedad-desconocida-en-la-republica-democratica-del-congo/

[Treyfish]

The situation of the 50-year-old Italian patient who returned to Lucca from

Congo

and was hospitalized for several days with

fever and anemia

is not yet entirely clear . The suspicion is that it could be a contagion of the mysterious disease that has caused several hundred cases (and about twenty deaths) in the African country: but the Italian authorities are pouring water on troubled waters. In fact, the man is fine and has already been discharged from the hospital.

.....As of yesterday, the Congolese Health Ministry teams, who left the capital with technical equipment, had not yet arrived on site. "The mention of anemia suggests Mycoplasma pneumonia, but it is too early to make a definitive diagnosis until further tests are reported," explained Paul Hunter, Professor of Medicine at UEA (University of East Anglia). Mycoplasma pneumoniae is a bacterium responsible for diseases that mainly affect the respiratory system.
The manifestations vary from mild upper respiratory infections (cold, pharyngitis, etc.) to more severe forms of pneumonia, often asymptomatic, but, when the immune defenses are reduced, the infection can lead to serious hematological and neurological complications. Hunter says, "reports of epidemics with deaths emerge somewhere in the world several times a year. Almost all of them are already known infections with limited global consequences."

For Jake Dunning, senior researcher and consultant in infectious diseases at the University of Oxford's Pandemic Sciences Institute, "there are multiple potential infectious causes for this unidentified disease outbreak, based on the symptoms described and the descriptions of those most affected, and there are also some possible non-infectious causes. Speculating about the causes of unidentified disease events, which happen periodically, especially in African countries, is not helpful and can sometimes be harmful."

In Congo and Cameroon, with the presence of the equatorial forest and a huge variety of animals, the majority of the planet's viruses are concentrated. An ideal place for the now well-known species jump (spillover), the natural process by which an animal pathogen evolves and becomes able to infect, reproduce and transmit itself within the human species, underlines Carlo Perno, head of Microbiology and immunology diagnostics, at the Bambino Gesù pediatric hospital, according to whom «it could be a respiratory infection. But we don't know how many people have actually been infected. In those areas only 3-4% of people are able to access medical care in hospital»

https://www.leggo.it/schede/malattia...e_lavora_oggi_ 8_12_2024-ma_di_che_malattia_si_tratta-6-8527350.html

[Treyfish]

Saturday 7 December 2024
Teodora Chiocci

, a young doctor who moved to

Congo

three months ago for Amka, a volunteer organization that for 25 years has been alongside men, women and children in the South of the world, who live in conditions of extreme poverty, speaks to the ANSA agency about the mysterious disease in the African country. According to the Congolese Ministry of Health, the epidemic has lasted for over 40 days and the confirmed deaths in health facilities are 27 out of 382 infected, but the official news now seems to scale down the alarm.

.....
«No precautions, we are waiting for the tests»

" I learned about this disease thanks to an alert message from the Italian embassy in Congo that arrived two days ago, warning of the health emergency in the province of Kwango, in the Panzi area, where a disease of still unknown origin was detected" and invited "all compatriots present in the area or in neighboring areas to take maximum precautions". The message recommended "in particular to avoid any travel to the Panzi area and the affected areas, except in cases of urgent need " . For now, explains the doctor, "no particular precautions are being taken. We are waiting to find out more and for the tests to arrive. The diagnosis is fundamental".
...... The alarm scaled down

The experts' assessment at the moment is that the epidemic can therefore be contained. A further 44 deaths have been recorded in neighbouring villages, but without a verification of the diagnosis, for a total of about 70 deaths in a vast area. However, a large part of the deaths is due to the total lack of treatment. The mortality rate is around 8%.

The Panzi area, where the disease developed, is extremely remote and sparsely populated. There is a small domestic airport in Kenge, the capital of the affected region, but access to the region is difficult, especially during the current rainy season. During this period, it can take 12-24 hours to reach the Kwango region from the capital by road.
There is no direct road between Kenge and Panzi, the epidemic area, which is much further south and close to the border with Angola. The area is also affected by the Yaka-Teke conflict with the 'Mabondo' militias active north of Kenge. As of yesterday, the Congolese Health Ministry teams, who left the capital with technical equipment, had not yet arrived on site.

https://www.leggo.it/schede/malattia...4-8525600.html

[Michael Coston]

WHO DON: Undiagnosed disease - Democratic Republic of the Congo




#18,473

We have a lengthy report this afternoon from the WHO on the (still) undiagnosed disease outbreak in the DRC. It was hoped that we'd have results this weekend, but it is the rainy season, and this is happening in a remote and poorly accessible region of the country, making access difficult.

For now, WHO is working to determine the cause - or causes - of this outbreak, and has declared the risk to the affected communities as high, while at a national level it is moderate.

For now, they state: Given the clinical presentation and symptoms reported, and a number of associated deaths, acute pneumonia, influenza, COVID-19, measles and malaria are being considered as potential causal factors with malnutrition as a contributing factor. We've been following this closely for several days and will obviously continue to do so.

Undiagnosed disease - Democratic Republic of the Congo
8 December 2024

Situation at a glance

Between 24 October and 5 December 2024, Panzi health zone in Kwango Province of Democratic Republic of the Congo recorded 406 cases of an undiagnosed disease with symptoms of fever, headache, cough, runny nose and body ache. All severe cases were reported to be severely malnourished. Among the cases, 31 deaths have been registered. The majority of cases reported are among children, particularly those under five years of age. The area is rural and remote, with access further hindered by the ongoing rainy season. Reaching it from Kinshasa by road takes an estimated 48 hours. These challenges, coupled with limited diagnostics in the region, have delayed the identification of the underlying cause.

Rapid response teams have been deployed to identify the cause of the outbreak and strengthen the response. The teams are collecting samples for laboratory testing, providing a more detailed clinical characterization of the detected cases, investigating the transmission dynamics, and actively searching for additional cases, both within health facilities and at the community level. The teams are also aiding with the treatment of patients, risk communication and community engagement. Given the clinical presentation and symptoms reported, and a number of associated deaths, acute pneumonia, influenza, COVID-19, measles and malaria are being considered as potential causal factors with malnutrition as a contributing factor. Malaria is a common disease in this area, and it may be causing or contributing to the cases. Laboratory tests are underway to determine the exact cause. At this stage, it is also possible that more than one disease is contributing to the cases and deaths.

Description of the situation

On 29 November 2024, the Ministry of Public Health of the Democratic Republic of the Congo reported to WHO an alert regarding increased deaths from an undiagnosed cause in Panzi health zone.

Between 24 October and as of 5 December 2024, Panzi health zone in Kwango Province has recorded 406 cases of an undiagnosed disease with symptoms of fever, headache, cough, runny nose and body ache and 31 deaths (Case Fatality Ratio or CFR of 7.6%). The reported cases had a peak in epidemiological week 45 (week ending 9 November 2024). The outbreak is still ongoing. According to a press briefing by the Ministry of Health on 5 December, there have been several additional deaths outside of health facilities (community deaths). These deaths still need to be investigated, characterized (age, gender etc) and verified.

Cases have been reported from nine out of 30 health areas in Panzi health zone: Kahumbulu, Kambandambi, Kanzangi, Kasanji, Kiama, Mbanza Kipungu, Makitapanzi, Mwini ngulu, and Tsakala Panzi. The majority of cases (95.8%) are reported from Tsakala Panzi (169), Makitapanzi (142) and Kanzangi (78) health areas.

In Panzi health zone, children aged 0-14 years represent 64.3% of all reported cases, with the age groups 0-59 months, 5-9 years, and 10-14 years accounting for 53%, 7.4%, and 3.9% of cases, respectively. Females constitute 59.9% of the total cases. Among the deaths, 71% are below the age of 15, with 54.8% of the total in children under the age of five years. All severe cases were reported to be malnourished. There are 145 cases aged 15 and above, of which nine died (CFR: 6.2%). Deaths have primarily occurred in the village communities.

The area experienced deterioration in food insecurity in recent months, has low vaccination coverage and very limited access to diagnostics and quality case management. There is a lack of supplies and transportation means and shortage of health staff in the area. Malaria control measures are very limited.

The clinical presentation of patients includes symptoms such as fever (96.5%), cough (87.9%), fatigue (60.9%) and a running nose (57.8%). The main symptoms associated with death include difficulty in breathing, anaemia, and signs of acute malnutrition. Based on the current context of the affected area and the broad presentation of symptoms, a number of suspected diseases need to be ruled out through further investigations and laboratory testing. These include but are not limited to measles, influenza, acute pneumonia (respiratory tract infection), hemolytic uremic syndrome from E. coli, COVID-19, and malaria.

Public health response

1. Leadership and coordination:

• Coordination has been strengthened at the national, provincial, and community levels. On 30 November 2024, the first Public Health Emergency Operations Center (PHEOC) meeting was held with all partners to address the alert, after which a rapid response team (RRT) from Kwango Province was deployed to Panzi. On 3 December 2024, a second PHEOC meeting was convened with partners, leading to the decision to deploy a national-level RRT to Panzi with support from WHO.
• Daily coordination meetings are being held at the national level, with provincial teams actively participating in ongoing planning and response.

2. Surveillance:

• A case definition has been developed based on clinical symptoms observed, which is guiding surveillance and reporting efforts.
• Active case search is being conducted in health facilities, including reviews of hospital registers to identify additional cases. Investigations and active case search are also being organized in the community.
• Data collection is ongoing, focusing on the preparation of a line list and detailed epidemiological analysis.
• Community deaths are being investigated to better understand transmission dynamics and the scope of the outbreak.

3. Case Management:

• A provincial RRT was deployed to Panzi on 30 November, and a multidisciplinary RRT from the national level, including WHO experts, was deployed on 7 December to investigate the outbreak, and reinforce the response.
• The teams are carrying medication to support case management and prevent more deaths.
• Efforts are underway to strengthen capacity of healthcare providers to ensure the best possible care for patients.

4. Laboratory:

• Laboratory equipment was transported to collect samples from cases and send for testing at INRB in Kinshasa. Additionally, RDTs for malaria and COVID-19 have been provided to assist in diagnosis.

5. Risk communication and community engagement:

• Key messages have been developed to enhance public awareness and encourage general preventive behaviors. These messages are being disseminated through community engagement, with sensitization campaigns underway.

6. Infection prevention and control:

• Infection prevention and control measures are being reinforced. Health and care workers have been briefed on key practices, including the proper use of masks, hand washing, and gloves, to reduce the risk of further transmission.

7. Logistics

• Logistical support is being provided for effective case management, including the transportation of samples to INRB Kinshasa for laboratory testing. Health facilities and hospitals in the most affected health areas are being supplied with appropriate medications and sampling kits to support the response.

WHO risk assessment

There are ongoing efforts to address the outbreak in Panzi health zone, however significant challenges in the clinical and epidemiological response remain, that increase the public health risk for the affected population. Severe cases with anaemia, respiratory distress, and malnutrition have been reported. The affected area is remote, complicating the assessment and response. The Integrated Food Security Phase Classification (IPC) for acute food insecurity levels in Kwango province increased from IPC 1 (acceptable) in April 2024 to IPC 3 (Crisis Level) in September 2024. This suggests a significant phase of increase in food insecurity and risk of severe acute malnutrition.

Symptoms such as fever, cough, headache, and body ache have been observed since 24 October, primarily through health worker reports, yet Integrated Disease Surveillance and Response (IDSR) data on baseline respiratory illness rates are not available for affected health zone to establish trends. Cases have been reported in family clusters, suggesting potential transmission dynamics within households, though additional investigation is needed. Furthermore, there is no information available on specific vaccination coverage, including childhood vaccination, in the affected health zone, leading to uncertainties about vaccine-deprived population immunity.

Gaps in case management have also been identified. Stock-outs of medications for treating common diseases frequently occur, and care is not provided free of charge, which could limit access to treatment for vulnerable populations.

The affected area’s remoteness and logistical barriers, including a two-day road journey from Kinshasa due to the rainy season affecting the roads and limited mobile phone and internet network coverage across the health areas, have hampered the rapid deployment of response teams and resources. Furthermore, there is no functional laboratory in the health zone or province, requiring the collection and shipment of samples to Kinshasa for analysis. This has delayed diagnosis and response efforts. The lack of sample collection supplies has further limited diagnostic capacity, leaving significant gaps in understanding the outbreak’s aetiology.

Insecurity in the region adds another layer of complexity to the response. The potential for attacks by armed groups poses a direct risk to response teams and communities, which could further disrupt the response.

Based on the above rationale, the overall risk level to the affected communities is assessed as high.

At the national level, the risk is considered moderate due to the localized nature of the outbreak within the Panzi health zone in Kwango province. However, the potential for spread to neighboring areas, coupled with gaps in surveillance and response systems, this assessment underscores the need for heightened preparedness.

At the regional and global levels, the risk remains low at this time. However, the proximity of the affected area to the border with Angola raises concerns about potential cross-border transmission, and continued monitoring and cross-border coordination will be essential to mitigate this risk.

The current confidence in the available information remains moderate, as significant gaps in clinical, epidemiological, and laboratory data persist.

WHO advice

To reduce the impact of the outbreak in the Panzi health zone and mitigate further spread, WHO advises the following measures:

Strengthening coordination mechanisms at all levels—national, provincial, zonal, and local—is critical for a unified response. Enhanced communication infrastructure, such as satellite phones, is required to overcome the limited network coverage in affected areas. Cross-border collaboration with Angola is also crucial to monitor for similar cases and prevent potential cross-border transmission.


Improving surveillance efforts is a priority to identify and respond to cases promptly. Active case searches should continue in both health facilities and communities, with a particular focus on areas reporting deaths and family clusters. Community-based surveillance must be strengthened to ensure early case detection and rapid response.

Careful characterization of the clinical syndrome and outcomes and an improved case definition based on the information collected will be necessary to understand the situation. In particular, data which clarify possibility of coinfection and multiple pathologies, and uncertainties in outcomes among vulnerable groups should be collected. The WHO has established the Global Clinical Platform to provide rapid turnaround of structured data analysis using anonymized case records; its use is recommended in the detailed capture of patient syndromes and outcomes.

Effective case management requires ensuring an adequate supply of essential medications to support treatment and prevent more deaths. RDTs for malaria should be distributed to facilitate differential diagnosis, while laboratory testing must be expedited through the shipment of samples to INRB Kinshasa to confirm or rule out suspected causes, including COVID-19 and influenza. Long-term laboratory capacity strengthening, and decentralization will be important in provision of diagnostic capability in the affected health zone.

Infection prevention and control (IPC) measures must be reinforced across all health facilities. Healthcare workers should receive training on IPC practices, including the proper use of personal protective equipment (PPE) such as masks and gloves, as well as strict hand hygiene protocols. These measures will reduce transmission risks within health facilities and improve the safety of healthcare delivery.

Risk communication and community engagement are essential to raising public awareness. Targeted messages should be disseminated to educate the public on respiratory illness symptoms, preventive measures, and the importance of seeking care early. Community leaders must be engaged to build trust and encourage adherence to public health guidance. Addressing misinformation and fears within the community is critical to ensuring effective collaboration in the response.

Logistical and security challenges also require attention. Strengthening logistical support for the deployment of teams and supplies will ensure timely access to affected areas. Contingency plans should be developed to address potential insecurity posed by armed groups, safeguarding response personnel and maintaining continuity in response activities.

Further investigations are needed to clarify whether anaemia observed in severe cases is linked to the outbreak. The main hypothesis of respiratory illness should be validated by studying its relationship with seasonal influenza and other potential factors. Additionally, historical outbreaks, such as that of typhoid fever which was reported in the health zone two years ago, should be reviewed to identify recurring vulnerabilities that may inform current response efforts. In addition, understanding general malnutrition rates and identifying cases of acute malnutrition in the affected population can inform appropriate nutritional care and prevent further deaths.

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